Post-Cycle Therapy, or PCT for short, is the concept of using certain testosterone stimulating and anti-estrogenic medications at the conclusion of a steroid cycle. The intention is to treat the suppression of natural testosterone that occurs with anabolic steroids use, and the subsequent hormonal imbalance when the drugs are stopped. This can result in a number of physical and psychological side effects such as muscle loss, decreased energy, reduced libido, sexual dysfunction, and depression. PCT practices have been increasingly popular over the years, though are largely supported by anecdote. Likewise, when we do find clinical papers that might support the concept, it is worthwhile news. A study recently appearing in the Journal of Sexual Medicine appears relevant to this discussion.
This paper involves a review of 49 case studies on men that were treated at two separate infertility clinics for low sperm count subsequent to testosterone use. The men were all taken off the hormones and treated with “traditional” PCT medications. HCG (human chorionic gonadotropin) was common to all treatment plans, and was given at a dose of 3,000 IU subcutaneously every other day. This was combined with tamoxifen (Nolvadex), clomiphene citrate (Clomid), anastrozole (Arimidex), or recombinant FSH (follicle-stimulating hormone), depending on the preference of the physician. The review found that normal sperm production was restored in 47 of the 49 treated men, with an average recovery time of 4.6 months. A 48th man had a documented pregnancy with his partner, and did not return for semen analysis. There was no significant difference in the recovery time based on type of testosterone used, nor that exact combination therapy.
The paper reports a potentially successful series of treatments for testosterone-induced sperm disruption. While that is seemingly very positive, the ultimate usefulness of this paper in our situation is going to be limited. Most notably, without a control group it cannot demonstrate causality, nor can we really quantify the effect. This paper does also focus on fertility, so the target was not testosterone. Still, it does underline at least the potential for these drugs to stimulate and restore the male hormonal axis, which involves both sperm and hormone production. It also, perhaps, might suggest that several variations of the normal PCT drug protocols are similarly useful, so long as the combination therapy involves HCG. The paper does encourage more research in this area, and if that were the result, it would be a highly worthy contribution. I’ll be sure to keep you informed if anything interesting comes up.
The Use of HCG-Based Combination Therapy for Recovery of Spermatogenesis after Testosterone Use. Evan P. Wenker BS, James M. Dupree MD, Gavin M. Langille MD, Jason Kovac MD, Ranjith Ramasamy MD, Dolores Lamb PhD, Jesse N. Mills MD and Larry I. Lipshultz MD. J Sex Med. Article first published online: 22 Apr 2015 DOI: 10.1111/jsm.12890